| NPI | 1700122306 |
|---|---|
| Former Name | JULIA C THEIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: KS 5375786061) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2013001303) |
| Enumeration Date | 2012-12-31 |
| Last Update Date | 2018-04-06 |